— Learning from Tokyo’s Leadership and Australia’s Experience —
Human papillomavirus (HPV) is widely known as the main cause of cervical cancer. However, HPV is also responsible for serious cancers in men, including anal cancer, penile cancer, and oropharyngeal (throat) cancer. HPV is therefore not a women’s health issue alone, but a significant public health concern for both sexes.
Globally, there is now a clear shift toward the understanding that HPV vaccination should be provided to both girls and boys as standard practice. In Japan, an important first step in this direction has already begun.
Progress in Tokyo and Japan
In Japan, HPV vaccination for boys is currently classified as voluntary (self-funded). However, led by Tokyo, a growing number of local governments have begun introducing public subsidies to support HPV vaccination for boys.
Tokyo Metropolitan Government initiatives
- The Tokyo Metropolitan Government has officially provided public information on HPV vaccination for males and has been working to establish appropriate systems and guidance.
References:
https://www.hokeniryo.metro.tokyo.lg.jp/kansen/info/hpv/hpvdansei
https://www.hokeniryo.metro.tokyo.lg.jp/kansen/info/hpv/hpvdansei_info - Through the Tokyo vaccine information portal, clear and accessible information on HPV vaccination and other immunisation programs is being actively disseminated to residents.
https://www.vaccine.metro.tokyo.lg.jp/
These are highly significant and commendable developments.
At the same time, they highlight an important challenge: access to preventive healthcare currently depends on where a person lives, creating regional inequities.
What Australia Demonstrates
Australia provides a valuable and practical comparison.
Since 2013, Australia has implemented gender-neutral HPV vaccination as part of its national, publicly funded immunisation program, delivered primarily through schools.
HPV vaccination coverage (at age 15)
- Girls: approximately 84.2%
- Boys: approximately 81.8%
(Official national data, 2023)
Reference:
https://ncirs.org.au/annual-immunisation-coverage-report-2023-summary/vaccination-coverage-adolescents
These data clearly demonstrate that when a government takes responsibility and institutionalises HPV vaccination, high coverage rates can be achieved among boys as well. Australia’s school-based delivery model has played a key role in this success.
Why Publicly Funded HPV Vaccination for Boys Is Needed in Japan
1. HPV-related cancers clearly affect men
HPV-related diseases are not conditions that affect only women. From the perspective of protecting men’s own health, HPV vaccination is essential.
2. Equity and fairness
Currently in Japan:
- Public subsidies vary by municipality
- Self-funded vaccination places a substantial financial burden on families
Without national-level implementation, health disparities will continue to widen.
3. Population-level prevention
When boys are vaccinated:
- Circulation of the virus decreases
- The risk of cervical cancer in women is further reduced
This is a critical public health benefit, not merely an individual choice.
Conclusion: Supporting the National Expansion of This Movement
The initiatives demonstrated by Tokyo and other Japanese municipalities show that this approach is both feasible and acceptable.
I strongly support the movement to expand publicly funded HPV vaccination for boys nationwide, in order to reduce HPV-related diseases for the next generation and to ensure equitable access to effective cancer prevention.
Australia’s experience shows that this is not a theoretical ideal, but a proven and achievable public health strategy.
Tatsuro Nagashima, FRACGP
